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氯吡格雷与替格瑞洛治疗急性非ST段抬高型心肌梗死的疗效及安全性比较
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| 篇名： | 氯吡格雷与替格瑞洛治疗急性非ST段抬高型心肌梗死的疗效及安全性比较 |
| TITLE： | |
| 摘要： | 目的：比较氯吡格雷与替格瑞洛治疗急性非ST段抬高型心肌梗死（NSTEMI）的临床疗效及安全性。方法：收集2013年10月－2015年11月我院心内科收治的NSTEMI患者160例，按随机数字表法分为观察组和对照组，各80例。两组患者均给予常规治疗，并以0.05 μg/（kg·h）持续静脉泵入盐酸替非罗班氯化钠注射液等，对照组在常规治疗基础上口服负荷剂量的硫酸氯吡格雷片300 mg，之后剂量改为75 mg，qd；观察组在常规治疗的基础上口服负荷剂量的替格瑞洛片180 mg，之后改为90 mg，bid。两组患者均治疗1个月。比较两组患者治疗前后血小板集聚率、左室射血分数（LVEF）、左室舒张末期内径（LVEDD）、纤维蛋白原水平，以及主要心血管事件（MACE）和出血事件发生率。 结果：治疗前，两组患者血小板集聚率比较，差异无统计学意义（P＞0.05）；治疗1周及1个月后，两组患者血小板集聚率显著降低，且观察组显著低于对照组，差异均有统计学意义（P＜0.05）。治疗1周后，两组患者LVEF、LVEDD水平比较，差异无统计学意义（P＞0.05）；治疗1个月后，观察组患者LVEF显著升高，且显著高于对照组，对照组患者LVEDD显著降低且显著低于观察组，差异均有统计学意义（P＜0.05）。治疗前、治疗3 d后，两组患者纤维蛋白原水平比较，差异无统计学意义（P＜0.05）；治疗1周、1个月后，两组患者纤维蛋白原水平均显著降低，且观察组显著低于对照组，差异均有统计学意义（P＜0.05）。观察组患者MACE事件发生率为11.25％，显著低于对照组的25.00％，差异有统计学意义（P＜0.05）；两组患者出血率比较（3.75％ vs. 7.50％），差异无统计学意义（P＞0.05）。结论：与氯吡格雷比较，替格瑞洛能有效抑制NSETMI患者血小板集聚，降低纤维蛋白原水平，提高心功能，改善预后，同时并未增加出血风险，安全性较高。 |
| ABSTRACT： | OBJECTIVE： To compare clinical efficacy and safety of clopidogrel and ticaprelor in the treatment of acute non-ST elevation myocardial infarction （NSTEMI）. METHODS： A total of 160 NSTEMI patients admited in cardiovascular disease department of our hospital during Oct. 2013-Nov. 2015 were divided into observation group and control group according to random number table， with 80 cases in each group. Both groups received routine treatment and continues intravenous pump of Tirofiban hydrochloride sodium chloride injection at 0.05 μg/（kg·h）. Control group was additionally given oral loading-dose of Clopidogrel hydrogensultate tablet 300 mg， adjusted to 75 mg， qd， on the basis of routine treatment. Observation group was additionally given oral loading-dose of ticaprelor 180 mg， adjusted to 90 mg， bid， on the basis of routine treatment. Both groups received 1 month of treatment. The rate of platelet aggregation， LVEF， LVEDD， fibrinogen levels， the incidence of MACE and bleeding events were compared in 2 groups before and after treatment. RESULTS： Before treatment， there was no statistical significance in the rate of platelet aggregation between 2 groups （P＞0.05）. After 1 week and 1 month of treatment， the rates of platelet aggregation in 2 groups were decreased significantly， and the observation group was significantly lower than the control group， with statistical significance （P＜0.05）. After 1 week of treatment， there was no statistical significance in the levels of LVEF or LVEDD between 2 groups （P＞0.05）. After 1 month of treatment， LVEF of observation group was significantly higher than that of control group， LVEDD was significantly lower than control group， with statistical significance （P＜0.05）. There was no statistical significance in the level of fibrinogen before treatment and after 3 d of treatment （P＜0.05）. After 1 week and 1 month of treatment， the levels of fibrinogen in 2 groups were decreased significantly， and the observation group was significantly lower than the control group， with statistical significance （P＜0.05）. The incidence of MACE in observation group was 11.25％， which was significantly lower than 25.00％ of control group， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of bleeding （3.75％ vs. 7.50％） between 2 groups （P＞0.05）. CONCLUSIONS： Compared with clopidogrel， ticaprelor effectively inhibits platelet aggregation in NSETMI patients， reduces the level of fibrinogen， improves cardiac function and prognosis and doesn’t increase the risk of bleeding with good safety. |
| 期刊： | 2017年第28卷第32期 |
| 作者： | 黄芳，李科宇，李迎，方立，祁珩，戴顺妮，邹斌 |
| AUTHORS： | HUANG Fang，LI Keyu，LI Ying，FANG Li，QI Heng，DAI Shunni，ZOU Bin |
| 关键字： | 替格瑞洛；替非罗班；心肌梗死；血小板 |
| KEYWORDS： | Ticagrelor； Tirofiban； Myocardial infarction； Platelet |
| 阅读数： | 314 次 |
| 本月下载数： | 6 次 |
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